Campuzano-Maya G

Language: Spanish
References: 176
Page: 411-442
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ABSTRACT

The hyperferritinemia, defined by a serum ferritin above 200 μg/L in women and above 300 μg/L in men, represents a challenge for the clinician. Based on the etiology, hyperferritinemia can be subdivided into three groups: the first corresponds to the caused by diseases frequently associated, including the metabolic syndrome, alcoholic liver disease, non-alcoholic liver disease and inflammatory processes (infections, chronic inflammatory diseases, autoimmune diseases, and some malignant processes); the second corresponds to the initiated by diseases associated in low frequency, which include hereditary hemochromatosis, some hematological diseases characterized by anemia and of permanent transfusional therapies; and a third group corresponding to the induced by diseases rarely associated, among which are the hereditary syndrome of hyperferritinemia and cataracts, the aceruloplasminemia, the atransferrinemia or hypotransferrinemia, the cutaneous porphyria tarda, the neonatal hemochromatosis, the overload of African iron, the Gaucher disease. The most important clinical aspect is to define, through clinical findings and simple and specialized studies, the associated cause of hyperferritinemia and intervene it as starting point of the management. From the patient’s point of view it is vital to perform ferrokinetic studies; in particular serum ferritin and transferrin saturation, and iron overload measurement in white organs through magnetic resonance, which presents high sensitivity and specificity. All this means the application of algorithms of handling and monitoring of the patient with hyperferritinemia. The management of the syndrome depends on the associated etiology and the absence or presence of iron overload; being, exclusively in this last case, the phlebotomy the best option.

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